T2 Diabetes and the heart of a hobbit.

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in 2008 I learned that I had T2 diabetes. Kaiser HMO doesn’t let a diabetic see an endo unless the patient is on insulin so I was treated by my PCP. I’ve had my ups and downs living with diabetes, but through it all my Kaiser doctor was a caring, supportive person.

I get my insurance through my employer. Effective January 1, 2014 they no longer offered Kaiser. I cried the day I found out because I had excellent relationships with Kaiser doctors that had lasted longer than most people have stayed married or been at the same job.

Frankly, my PPO PCP is not as warm as my Kaiser doctor. Is this a good enough reason to find another doctor?

After I’d receive my A1c and other results from Kaiser (I really miss having all my blood tests results show up in my inbox of my Kaiser member page!), my PCP doctor would call me and we’d discuss the actions I was currently taking or needed to take.

After my PPO dermatologist (he treats my rare T-cell disorder received my January blood test results his office called me to discuss them. I asked if I could speak with the doctor and he called me.

But there wasn’t a phone call from my PPO PCP after he received the results of the blood tests he ordered. Instead, I opened up the mailed lab results and saw the following typed in CAPS:

YOUR BLOOD GLUCOSE IS NOT ADEQUATELY CONTROLLED. IN ADDITION, WE NEED TO TALK ABOUT TESTING TO CHECK INTO YOUR ELEVATED CALCIUM LEVEL. PLEASE MAKE APPOINTMENT WITH ME TO DISCUSS THESE ISSUES.

My Kaiser PCP knew that I had to take half a day off from work for each doctor appointment, which is why I preferred phone consultations. I think I need to find out if this doctor is willing to do the same thing.

Although I like to believe that my thinking is in shades of grey, I tend to think in terms of black or white; that all or nothing mentality.

I was raised as a Roman Catholic. I remember giving things up for Lent as a child (usually chocolate bars), but I don’t recall if I actually lasted the entire season of Lent.

After being away from organized religion for over three decades I recently joined a church. This time I chose the Episcopal Church. It is similar to the Catholic faith so it doesn’t feel strange to me. One of the things that drew me to this branch of Christianity is that they ordain woman clergy. Being female this what I always hoped the Catholic Church would do one day. I am still waiting. *tapping my foot impatiently*

This is my first Lenten Season (which began on Ash Wednesday, March 5) as a member of my new church. Our church’s Reverend said we didn’t have to give something up for Lent, but I decided I wanted to. Something that I really enjoy, something that would makes it a true sacrifice. I hit upon it immediately; the foods that I cannot eat just one small portion of — cakes, cookies, pies, bread, pizza, pasta, rice. I decided that the most logical way to do this was to give up grains for Lent. This is my all or nothing thinking, instead of just giving up wheat, I’m giving up all grains. *rolling my eyes at myself*

But on the positive side, I’ll be eating less junk food and less carby food, which is good for my health in general, and my T2 diabetes in particular.

Last night my dad and I went to an all you can eat Chinese buffet. I ignored the rice and noodles and enjoyed beef, pork, chicken, crab, and vegetables. I didn’t even miss the carby foods made from grains!

Some people say you shouldn’t share what you are giving up for Lent, but I think it is up to the individual. I am sharing with the diabetes community, not because I am boasting, but because I need the support.

Since daylights savings started it my state today, this means I’ll actually be getting up at 3:00 instead of 4:00 tomorrow morning (the body knows!) so I’m headed to bed! Night!

I miss all forms of baked goods. Alas, they wreck havoc on my blood sugar. So I was excited to find an online recipe for a breakfast bun made with almond flour (I use Honeyville Farms Blanched Almond Flour because it is finely ground). Breakfast was two eggs cooked in extra virgin coconut oil with chorizo sausage and mushrooms, topped with half an avocado, with an almond bun side. It was an awesome meal!

Now the batter was supposed to fill six wells of a Muffin Top pan. Mine only filled five because I stuck the melted butter in the fridge for a little bit (don’t ask me why) which ended up changing the consistency of the batter. The finished product still tasted delicious.

The next day I topped a bun with a squeeze pack of Justin’s Maple Almond Butter (8 g carbs) for a filling snack that didn’t taste too sweet.

I think next time I make these I’ll put caramelized onions and green chili peppers in three of them. For the other three I’ll use the amount of sugar called for in the recipe (I used a third of it for my first attempt) and add cinnamon. So I’ll have savory buns and sweet buns.

Here’s the link to website with the recipe in case you’d like to do your own kitchen experiments:

On the work mornings I am running late I invariably find myself running for the bus. Ideally I would like to take up running as exercise. Though I don’t know if this is the wisest choice, because I end up winded and wheezing after running a short distance (I know this will decrease as I become fitter), but what really concerns me is that I have osteoarthritis (OA) in both ankles and knees.

Osteoarthritis is known as the “wear and tear” arthritis. My primary care doctor said anyone over the age 30 already has it.

From the NIH website:

Osteoarthritis. Some people with knee problems have a form of arthritis called osteoarthritis. In this disease, the cartilage gradually wears away and changes occur in the adjacent bone. Osteoarthritis may be caused by joint injury or being overweight. It is associated with aging and most typically begins in people age 50 or older. A young person who develops osteoarthritis typically has had an injury to the knee or may have an inherited form of the disease.

In 2011 I suffered a tibial plateau fracture in my left leg as a result of a fall on a rain-slicked metal plate in the sidewalk. It was a simple fracture so no surgery was needed. Two years later my knee started hurting as much as it did during the recovery period. I knew I had the beginnings of OA prior to the accident. An x-ray was taken and it was discovered that I also have osteopenia in that knee.

From the NIH website:

Osteopenia is a term to define bone density that is not normal but also not as low as osteoporosis. By definition from the World Health Organization osteopenia is defined by bone densitometry as a T score -1 to -2.5. There are many causes for osteopenia including calcium and vitamin D deficiency and inactivity. Genetics plays an important role in a person’s bone mineral density and often Caucasian women with a thin body who are premenopausal are found to have osteopenia. Correction of calcium and vitamin D deficiency and walking 3 to 5 miles a week can often improve bone density in the hip and spine.

Three years after being Dx with type 2 diabetes I asked my PCP if I could get tested for vitamin D. He didn’t think it was necessary. I had started taking supplements after reading that some people with diabetes may have a vitamin D deficiency. I stopped the supplement and convinced him to let me be tested. The result was that I was one point above being low.

It sounds like walking might be a better option for me than running. On Friday morning I ran part of the way to the bus, and I must admit that it actually felt good! But then while moving out of the way of the rude man on the Segway I twisted my ankle and ended up walking/limping the rest of the way to the bus stop.

A wretched cold kicked into high gear on Friday night, so I ended up resting on Saturday. My ankle was still hurting yesterday so this was a good thing. Today I felt a little better so I walked to the store instead of taking a bus. It took 30 minutes instead of 20 but I was happy that my body was getting exercise.

I know that decreasing my weight (and excess body fat) will decrease the pain from osteoarthritis and osteopenia. And regular exercise will help with this!

Now my stupid cold has moved into my chest. Once my body has recovered from this viral attack I will add walking as exercise back into my life (I did this when I was first Dx with T2 in 2008 and it really helped to bring my blood sugars down).

I’ve gotten quite a few 90 glucose readings recently. When I got one this afternoon I didn’t freak out, I merely made a tasty 17 g carbs snack and went about my day. I’m wondering if a 90 is a perfectly good reading for my T2 diabetic body? Maybe I don’t need to eat anything when I see this number on my meter (unless my stomach is growling). After all, 90 isn’t a low. Any thoughts on this?

Okay, so it wasn’t technically a low (under 70), but I felt off-kilter so I checked my blood sugar after breakfast and found it to be 90. The combination of a moderate carb meal and oral meds does that to me sometimes. Now some people would rejoice at a 90 glucose reading but that isn’t in my comfort zone.

Now I’ve read in other peoples’ blogs that it isn’t a good idea to indulge in junk food as a way of bringing up your blood sugar, and to tell you the truth, I had never done that (I always got some juice). Well, this time I threw caution to the wind and ate a German Chocolate cupcake! I was sure that would do the trick and then some.

An hour passed and I still wasn’t feeling quite right so I checked my bg again. This time it was 81! What was going on here! So I headed to the vending machine for some juice. On the few occasions when I’ve been under 70 at work I’d drink a can of straight orange juice. But I have a slight food intolerance to oranges and didn’t feel like doing more harm to my body (I knew that cupcake was going to sneak up on me and cause havoc), so I decided to go for the apple juice. When I retrieved the can from the machine I was surprised to see that it was apple-cranberry. I turned the can around and read that it had corn syrup in it. Not! So I gave it to a coworker, and decided to buy the orange juice after all. Alas, it was not meant to be. The orange juice was sold out. I was beginning to run out of options (I don’t like the taste of soft drinks, with the exception of anything made by Virgil’s Micro-Brewed — they use natural herbs and spices and cane sugar), so I decided on a V-8, which turned out to have 14 grams of carbs. I hadn’t had one in years (tomatoes are another food that my body hates) and it tasted so good!

I tested my blood sugar an hour later and it was up to 144. I thought it would be much higher. Sometimes Often times Most times I can’t predict what number is going to pop up on my meter.

What I learned from this is that I either need to go back to having kid sized lunchbox cartons of orange or apple juice stashed in my desk drawer, or I need to buy a bottle of GlucoLift tablets (the berry sounds good!).

I received my newest A1c result today. I’m happy with my progress. And so is my PCP (at my HMO, non-insulin dependent diabetics aren’t allowed to see Endos. My guess is that this is a cost saving measure for the HMO). In response to my lab results my doctor sent me an email titled “Way to Go!”

Looking at my A1c history I can sum it by saying, “When I work the program it really does work for me! And when I fall off the wagon I fall into a well on an abandoned property!”

I have become complacent in the past and that’s when the numbers go up and up and up. I know now to never turn my back on the sharp-toothed beast that is diabetes.

On Thursday morning my fasting blood sugar was 111. That’s because during my brief visit to the Wednesday Night Farmers Market I had Indian Vegetable Curry (no rice and no Naan bread) instead of a sweet crepe (which would have been filled with lovely things that aren’t lovely for people with diabetes). Amazing how this works. My long term goal is to eat mostly moderate carb dinners, with an occasional planned cheat meal.

Before diabetes I’d eat candy or ice cream at the movies. After diabetes entered my life I’d sneak low carb food into the theatre. This weekend I wanted to figure out a way to eat during the movie without resorting to bringing in outside food.

I decided to go with the lowest carb thing on the menu — the 100% beef hot dog. I had them take it out of the wrapper and put it in an open box and pour “nacho” cheese on it (I don’t want to know what was in the cheese! Maybe another day I’ll Goggle the ingredients!). I added green peppers from the relish bar, then I cut the hot dog into bite size pieces and ate them off the bun, which I used as a plate.

Two hours later when I checked my blood sugar I was pleased to see that it was 95.

Of course the best way to handle this would have been to eat a healthy before going to the movies. Sometimes it works out that way, sometimes it doesn’t. I like having a Plan B.